Episiotomy—A Birmingham Obstetrician’s View

Episiotomy—the small surgical incision made to enlarge the vaginal opening shortly before a baby is delivered—was not a commonly accepted birth procedure until the twentieth century.  But by mid-century, over half of vaginal deliveries included an episiotomy. The idea was that making a small incision would reduce the risk of a large spontaneous tear in the tissues surrounding the vagina (the perineum), as the infant’s head delivered.

As physicians, we want to offer our patients only medical interventions that—based on solid evidence—actually benefit them. By the 1980s, we began to realize that the medical benefits of routine episiotomy were uncertain.  According to recent data, less than 12% of women delivering vaginally now have an episiotomy. We do not consider episiotomy a routine part of childbirth. Read more

Gynecologic Cancers–Recognize What’s Not Normal for You

Research tells us that Americans fear cancer more than any other health event, even though heart disease is the leading cause of death. Much of this fear comes from the belief that cancer or cancer death is just a matter of random chance, something we are powerless to prevent. But let’s look at the actual facts about gynecologic cancers.

We refer to any cancer that begins in a woman’s reproductive organs as a gynecologic cancer. About 100,000 women are newly diagnosed with a gynecologic cancer each year, and these cancers cause nearly 40,000 deaths annually.  A woman’s risk for gynecologic cancer increases with age. As we see you each year for your well-woman visit, we want to help you understand what you can do to prevent these cancers or discover them early. Read more

The Thin, Fuzzy Line between Medical Science and “Alternative” or “Complementary” Medicine

As physicians we try to draw a clear line when we make recommendations to our patients. Is the treatment choice based on strict, evidence-based medical science, is it based on the doctor’s years of experience, or is there really nothing factual to support a recommendation? Is it just an opinion, or worse, part of the darker side of health care, a profit-driven option?  By explaining these differences, we help our patients to make informed choices. Recently one of the U.S.’s most prestigious medical research and teaching hospitals, the Cleveland Clinic, promised disciplinary action against the Medical Director of its own Wellness Institute, Dr. Daniel Neides.. Read more

A Brief “Thank You” from Dr. Sparks

Now and then, most of us think about the people to whom we wish we said “thank you” much more often.  For the physicians at Sparks & Favor, it’s a long list, but the RNs who care for our patients during labor and delivery surely rank near the top.

Our nurses make an important difference for our patients every day. Sometimes they anticipate a mom’s rising need for comfort measures and offer suggestions early, allowing mom to remain in control of her labor. There are also difficult moments when a nurse’s timely recognition of a true obstetric emergency is critical to the wellbeing of mom and baby.

Over my career as an obstetrician, I have practiced in quite a variety of situations from my years as a young army doctor where four of us delivered nearly 1200 babies a year to my time on the faculty at UAB supervising residents first learning to deliver a baby. I have seen trends come and go. My confidence in my nursing colleagues here comes from a years-long positive working relationship, but also from a number of specific commitments Brookwood has made over these years to maternity care. I’d like to share some of these with our patients. Read more

From Dr. Favor: A Word about Pancreatic Cancer

The pancreas is a small organ behind the stomach. It produces hormones like insulin and enzymes that help digest food. Like other very serious cancers, pancreatic cancer usually doesn’t cause noticeable symptoms until it reaches an advanced stage. There is no reliable test to find pancreatic cancer at an early stage. With so little available to fight this disease, you might wonder why, as a women’s physician, I am talking about pancreatic cancer. Read more

Do Calcium Supplements Cause Heart Disease?

Are you confused about calcium? We can’t blame you. In the 1980s, about a fourth of women over 60 were taking calcium supplements. Among their daughters who’ve now reached this age, over 60% rely on calcium supplements to boost what their diet provides.* But in just the past few months, health news headlines have led women in all directions about whether to throw away their calcium supplements or buy more. Read more

Pelvic Organ Prolapse–a common women’s health problem

Actress Kate Winslett’s recent public disclosure of a very personal problem with bladder control was, in my view, an extraordinary gesture of kindness and support for millions of women around the world who suffer with a similar condition. Past generations of women have been reluctant to discuss such problems, even with their physicians—many believing they alone endured the discomfort and embarrassment. Such openness from a celebrity like Ms. Winslett is helpful; at least, I hope that my patients find encouragement from her message.

In reality, the condition affects millions of women who usually begin to notice symptoms around menopause. As baby-boomers pass into this age group, the prevalence of pelvic organ prolapse (POP) is on a steep rise.  The actual fact is that Americans buy more incontinence products than menstrual pads (Washington Post, Dec. 22, 2015).

Pelvic organ prolapse (or pelvic relaxation) is a very general term that describes the weakening of support structures, the muscles and connective tissue that hold the pelvic organs in place. Read more

Preconception Health and Health Care–(something to think about even if you’re not planning a pregnancy!)


First things first–why did I add the subtitle? Every woman can benefit from most of these recommendations even if her pregnancy plans are uncertain or a long way off. Preconception health care focuses on improving wellness, now and for life.  Keep in mind as well that about half of pregnancies in the United States are not planned.

Your annual well-woman visit is a good time to begin this discussion with your doctor. Think carefully about your life goals and plans. If pregnancy is not your intention, we will help you consider your birth control options including long-acting reversible contraception.

So what does preconception health care involve? Read more

Weight Loss: Counting Calories and Nutrients, or Is There Another Way?

Earlier this year, a group of scientists and physicians reported the results of a weight-loss study in the Annals of Internal Medicine (a peer review journal publishing high-quality research). Participants in the study were overweight adults with at least one symptom of metabolic syndrome (high blood pressure, high cholesterol, or high blood sugar). Individuals with these symptoms have higher risk for developing cardiovascular disease or diabetes. Read more

For Moms: Your ‘Tween Daughter and Healthy Puberty

As daughters enter the second decade of life, moms begin to alert themselves to subtle changes that signal the beginning of puberty. You look forward—with a little hesitation–to helping your pre-teen navigate the transition to young woman. For many of you, we shared the moment of your daughter’s birth, we have enjoyed hearing about childhood milestones at your annual visits, and occasionally you bring us questions about what to expect next.

As the mother of a young daughter, I share many of your concerns, though my medical training answers the basic questions. Your child is about to enter a phase of rapid development like no other time since infancy, and the question we hear most often concerns “what is normal?” I’d like to offer a few facts to help you gauge the answer. Read more